lock Open Access lock Peer-Reviewed




Octagenarians: results of 3659 necropsies

José Carlos R IgléziasI; Artur Lourenção JrI; Luís Alberto DallanI; Paulo Sampaio GutierresI; José Antônio F RamiresI; Noedir A. G StolfI; Sérgio Almeida de OliveiraI; Geraldo VerginelliI; Adib D JateneI

DOI: 10.1590/S0102-76381993000100004


Between January 1978 and December 1990, 3659 autopsies were performed in our Institution, of which 106 of the patients were > 80 years old. Of these patients, 55 (51.88%) were male and 51 (48.11%) female, and the mean age was 83.66 (80 to 93) years old. The main symptoms presented prior to death were: angina in 40.56%, dyspnea in 25.47%%, and syncope in 8.49% of the patients. In 47.16% the symptoms had begun more than six months before. The systems related to the cause of death were found to be: cardiovascular in 74.52%, respiratory in 10.37%, digestive in 9.43%, nervous in 1.88%, urinary in 1.88% and others in 1.88%. Among the cardiovascular deaths: 56.96% were due to coronary artery disease, 12.65% due to myocardiopathy, 10.12% due to thoracic aortic aneurysm and 8.86% were atributed to arrythmias. It was considered that: the cardiovascular system was the major determinant of death in 74.52%, coronary disease was responsible for 56.96% of the cardiovascular deaths, standard revascularization in this group has a mortality rate of 8.5% and that primary angioplasty has had a success rate of 93.2%. It was therefore concluded that the patients of at least 80 years old should be maintained near their physician or the time between their medical check-up be reduced in order to significantly improve their quality and expectancy of life.


No InCór, no período compreendido entre janeiro de 1978 e dezembro de 1990, foram realizadas 3659 necropsias, das quais 106 relativas a pacientes com idade > 80 anos. Destes, 55 (51,88%) eram do sexo masculino e 51 (48,11%) do feminino. A média de idade foi igual a 83,66 (80 a 93 anos). Dentre os principais sintomas (Gráfico 3) apresentados figuravam: a angima do peito em 40,56%, a dispnéia em 25,47% e a síncope em 8,49 deles. Em 47,16% dos pacientes os sintomas haviam se iniciado a mais de seis meses. Dentre os sistemas desencadeantes dos óbitos (Gráfico 1), encontramos o cardiovascular em 74,52%, o respiratório em 10,37%, o digestivo em 9,43%, o nervoso em 1,88%, o urinário em 1,88% e outros em 1,88%. Entre os óbitos cardiovasculares (Gráfico 2), 56,96% foram devidos a coronariopatia, 12,65% a miocardiopatia, 10,12% devido aos aneurismas da aorta e 8,86% atribuídos às arritmias. Baseados na casuística prévia e considerando: 1) que o sistema cardiovascular foi o maior determinante dos óbitos (74,52%); 2) que as coronariopatias foram responsáveis por 56,96% dos óbitos cardiovasculares; 3) que a revascularização convencional neste grupo tem mortalidade atual de 8,5%; 4) que a angioplastia primária foi bem sucedida em 93,2%, concluímos que ambas, a qualidade e a expectativa de vida, podem ser melhoradas trazendo o octogenário para próximo do médico, ou reduzindo o intervalo entre suas avaliações.
Full text available only in portuguese PDF format.


1. ARONOW, W. S.; AHN, C.; KRONZON, I. - Prognosis of congestive heart failure in elderly patients with normal versus abnormal left ventricular systolic function associated with coronary artery disease. Am. J. Cardiol., 66: 1257-1259, 1990. [MedLine]

2. CHAITMAN, B. R.; RYAN, T. J.; KRONWAL, R. A.; FORSTER, E. D.; FROMMER, P. L.; KILLIP, T. - Coronary artery surgery study (CASS). Comparability of 10 year survival in randomized and randomizable patients. J. Am. Coll. Cardiol., 16: 1071-1078, 1990. [MedLine]

3. COHN, J. N. & JOHNSON, G. and Veterans Administration Cooperative Study Group. - Heart failure with normal ejection fraction: the V-Heft study. Circulation, 8 (Suppl. 3):48-53, 1990.

4. IGLÉZIAS, J. C. R.; DALLAN, L. A. O.; OLIVEIRA, S. F.; RAMIRES, J. A. F.; OLIVEIRA, S. A.; VERGINELLI, G.; PILEGGI, F.; JATENE, A. D. - Revascularizacáo do miocardio no paciente octogenário. Rev. Bras. Cir. Cardiovsc., 5: 183-186, 1990.

5. KOWALCHUK, G. J.; SIU, S. C.; LEWIS, S. M. - Coronary artery disease in the octogenarian: angiographic spectrum and suitability for revascularization. Am. J. Crdiol., 66: 1319-1323, 1990.

6. LOOP, F. D.; LYTLE, B. W.; COSGROVE, D. M.; GOORMASTIC, M.; TAYLOR, P. C.; GOLDING, L. A. R.; STEWART, R. W.; GILL, C. C. - Coronary artery bypass graft surgery in the elderly. Cleveland Clin. J. Med., 55: 23-34, 1988.

7. MACAYA, C.; ALFONSO, F.; INIGUEZ, A.; ZARCO, P. - Long term clinical and angiographic follow-up of percutaneous transluminal coronary angioplasty in patients greater than or equal to 65 yers of age. Am. J. Cardiol., 66: 1513-1515, 1990. [MedLine]

8. MULLANY, C.J.; DARLING, G. E.; PLUTH, J. R.; ORSZULAK, T. A.; SCHAFF, H. V.; ILSTRUP, D. M.; GERSH, B. J. - Early and late results after isolated coronary artery bypass surgery in 159 patients aged 80 years and older. Circulation, 82 (Supl. 4):229-236, 1990.

9. RENKIN, J.; MELIN, J.; ROBERT, A.; RICHELLE, F.; BACHY, J. L.; COP, J.; DETRY, J. M.; WIJNS, W. - Detection of restenosis after successful coronary angioplasty: improved clinical decision making with use of logistic model combining procedural and follow-up variables. J. Am. Coll. Cardiol., 16: 1333-1340, 1990. [MedLine]

10. ROBERTS, W. C.; KRAGEL, A. H.; POTKIN, B. N. - Ages at death and sex distribution in age decade in fatal coronary artery disease. Am. J. Cardiol., 66: 1379-1381, 1990. [MedLine]

11. WEINTRAUB, W. S.; COHEN, C. L.; CURLING, P. E.; JONES, E. L; CRAVER, J. M.; GUYTON, R.; KING III, S. B.; DOUGLAS, J. S. - Results of coronary surgery after failed elective coronary angioplasty in patients with prior coronary surgery. J. Am. Coll. Cardiol., 16: 1341-1347, 1990. [MedLine]

Article receive on Sunday, March 28, 1993

CCBY All scientific articles published at are licensed under a Creative Commons license


All rights reserved 2017 / © 2023 Brazilian Society of Cardiovascular Surgery DEVELOPMENT BY